Chemokine is known as a basic protein having endogeneous leukocyte chemotactic and activating abilities and heparin-binding abilities. At present, it is considered that chemokine is related to not only the control of infiltration of specific leukocyte at the time of inflammations and immune responses but also the development and homing of lymphocyte under physiological conditions and migration of hemocyte precursor cells and somatic cells.
Differentiation, proliferation and cell death of hemocytes are controlled by various types of cytokine. In the living body, inflammations are found topically and differentiation, maturation and the like of lymphocytes are carried out at certain specified sites. That is, various necessary cells migrate into certain specified sites and accumulate therein to cause a series of inflammations and immune responses. Accordingly, migration of cells is also an indispensable phenomenon in addition to differentiation, proliferation and death of cells.
Migration of hemocytes in the living body starts firstly in the development stage by the shift of hematopoiesis started in the AGM (aorta gonad mesonephros) region into permanent hematopoiesis in bone marrow via fetal liver. Furthermore, precursor cells of T cells and thymus dendritic cells migrate from the fetal liver into the bone marrow and then into the thymus gland and cytodifferentiate under thymus environment. The T cell which received clone selection migrates into secondary lymphoid tissues and takes part in an immune response in the periphery. The Langerhans' cell of the skin activated and differentiated by capturing an antigen migrates into the T cell region of a topical lymph node and activates naive T cell therein as a dendritic cell. The memory T cell performs its homing again into the lymph node via lymphatic and blood vessels. Also, B cell, T cell in the intestinal epithelium, γδ T cell, NKT cell and dendritic cell migrate from bone marrow without passing through the thymus gland and differentiate to take part in an immune response.
Chemokine is deeply concerned in the migration of various cells. For example, in order to effect efficient encounter of an antibody-captured mature dendritic cell with a naïve T cell and a memory T cell, MIP 3β (macrophage inflammatory protein 3β), SLC (secondary lymphoid tissue chemokine) and CCR7 as a receptor thereof are taking an important role in the migration and homing of these cells to a topical lymphoid tissue. T cells and dendritic cells necessary for controlling antigen-specific immune response are hardly observed in the secondary lymph node of PLT mouse having defection in the SLC expression (J. Exp. Med, 189 (3), 451 (1999)).
MDC (macrophage-derived chemokine), TARC (thymus and activation-regulated chemokine) and CCR4 as a receptor thereof are taking an important role in the migration of Th2 cell into a topical region in immune and inflammatory responses in which the Th2 cell is concerned. In a rat fulminant hepatitis model (P. acnes+LPS), an anti-TARC antibody inhibited increase of the blood ALT level and increase of the expression quantity of TNFα and FasL in the liver, and improved rat lethality (J. Clin. Invest., 102, 1933 (1998)). Also, in a mouse OVA-induced airway hypersensitivity model, an anti-MDC antibody reduced the number of eosinophils accumulating in the lung interstitium and inhibited the airway hypersensitivity (J. Immunology, 163, 403 (1999)).
MCP-1 (monocyte chemoattractant protein-1) and its receptor CCR2 are concerned in the infiltration of macrophage into inflammatory regions. In a rat anti-Thy1.1 antibody glomerular nephritis model, an anti-MCP-1 antibody showed an effect to inhibit infiltration of monocyte and macrophage into the uterine body (Kidney Int., 51, 770 (1997)).
Thus, chemokine receptors are greatly concerned in the control of inflammatory and immune responses through a mechanism in which they are expressed in various specific cells at a specified period, and the effector cells are accumulated into a region where the chemokine is produced.
Acquired immunodeficiency syndrome (called AIDS) which is induced by human immunodeficiency virus (hereinafter referred to as “HIV”) is one of the diseases of which their therapeutic methods are most earnestly desired in recent years. Once infection with HIV is completed in a CD4-positive cell which is a principal target cell, HIV repeats its proliferation in the body of the patient and, sooner or later, completely destroys T cell which takes charge of the immunological function. During this process, the immunological function is gradually reduced to cause fever, diarrhea, lymph node enlargement and the like various immunodeficiency conditions which are apt to cause complications with pneumocystis carinii pneumonia and the like various opportunistic infections. Such conditions are the onset of AIDS, and it is well known that they induce and worsen Kaposi sarcoma and the like malignant tumors.
As the recent preventive and therapeutic methods for AIDS, attempts have been made to, e.g., (1) inhibit growth of HIV by the administration of a reverse transcriptase inhibitor or a protease inhibitor and (2) prevent or alleviate opportunistic infections by the administration of a drug having immunopotentiation activity.
Helper T cells which take charge of the central of immune system are mainly infected with HIV. It is known since 1985 that HIV uses the membrane protein CD4 expressing on the membrane of T cells in the infection (Cell, 52, 631 (1985)). The CD4 molecule is composed of 433 amino acid residues, and its expression can be found in macrophages, some B cells, vascular endothelial cells, Langerhans' cells in skin tissues, dendritic cells in lymphoid tissues, glia cells of the central nervous system and the like, in addition to the mature helper T cells. However, since it has been revealed that the infection with HIV is not completed by the CD4 molecule alone, a possibility has been suggested on the presence of factors other than the CD4 molecule, which are related to the infection of cells with HIV.
In 1996, a cell membrane protein called Fusin was identified as a factor concerned in the HIV infection of other than CD4 molecule (Science, 272, 872 (1996)). It was shown that this Fusin molecule is a receptor of a stromal cell-derived factor-1 (Stromal Derived Factor-1: to be referred to as SDF-1) (that is, CXCR4). In addition, it was shown also that SDF-1 specifically inhibits T cell-directional (X4) HIV infection (Nature, 382, 829 (1996), Nature, 382, 833 (1996)). That is, it is considered that the HIV infection was inhibited through the deprivation of a foothold for HIV to infect upon cells, effected by the binding of SDF-1 to CXCR4 prior to that of HIV.
In addition, it was discovered during the same period that CCR5 as another chemokine receptor which is the receptor of RANTES, MIP-1α and MIP-1β is also utilized in infecting macrophage-directional (R5) HIV (Science, 272, 1955 (1996)).
Accordingly, a substance which can scramble for HIV and CXCR4 or CCR5, or which can bind to HIV virus to provide such a state that said virus cannot bind to CXCR4 or CCR5, may become an HIV infection inhibitor. In addition, there is a case in which a low molecular compound discovered in the beginning as an HIV infection inhibitor was found to be a CXCR4 antagonist in reality (Nature Medicine, 4 72 (1998)).
Based on the above, it is considered that chemokine receptors are deeply related to various inflammatory diseases, immune diseases such as autoimmune diseases or allergic diseases, or HIV infection. For example, it is considered that they are related to asthma, nephritis, nephropathy, hepatitis, arthritis, rheumatoid arthritis, rhinitis, conjunctivitis, ulcerative colitis, and the like, rejection in organ transplantation, immunosuppression, psoriasis, multiple sclerosis, infection with human immunodeficiency virus (acquired immunodeficiency syndrome and the like), atopic dermatitis, uticaria, allergic bronchopulmonary aspergillosis, allergic eosinophilic gastroenteritis, ischemic reperfusion injury, acute respiratory distress syndrome, shock accompanying bacterial infection, diabetes mellitus, cancer metastasis, arteriosclerosis and the like.
On the other hand, there is a description that a compound represented by formula (Z) is useful for the inhibition of platelet agglutination:

wherein Aiz and Bjz are each independently selected from carbon, nitrogen, oxygen or sulfur (however, at least one atom of Aiz is carbon, and at least one of Bjz is carbon);
each of the spiro-bicycles formed by Aiz and Bjz may be partially unsaturated in some cases,
pZ and qZ are each independently a number of from 2 to 6,
mZ is a number of from 0 to pZ,
R10z may be the same or different from one another and are incoherent substituents each independently selected from hydrogen, alkyl, halo-substituted alkyl, alkenyl, alkynyl, cycloalkyl, ═O, ═S and the like,
nZ is a number of from 0 to qZ,
R0z may be the same or different from one another and are incoherent substituents each independently selected from hydrogen, alkyl, halo-substituted alkyl, alkenyl, alkynyl, cycloalkyl, ═O, ═S and the like,
-(Lz)- is a bond, or a substituted or unsubstituted divalent chain consisting of from 1 to 10 atoms selected from carbon, nitrogen, sulfur and oxygen,
Qz is a basic group comprising one or two or more of basic radicals, and R3z is an acidic group comprising one or two or more of acidic radicals (e.g., see WO 97/11940).
Also, there is a description that a compound represented by formula (Y) is 10 useful as a chemokine receptor modulator:

wherein mY or 1Y each independently represents 0, 1, 2, 3, 4 or 5,
R1Y represents hydrogen, C1-8 alkyl, C2-8 alkenyl, C2-8 alkynyl or the like,
WY represents a single bond, C1-3 alkyl, C1-3 alkyl substituted with oxo, etc., or the like,
QY represents —NR2—, —O—, —S—, —S(O)— or —SO2—,
XY represents a single bond, C1-3 alkyl, C1-3 alkyl substituted with oxo, etc., or the like, and
YY-ZY ring represents phenyl, naphthyl or heteroaryl. However, definition of each symbol is a partial extract (e.g., see WO 98/25605).
In addition, there is a description that a triazaspiro[5.5]undecane derivative compound represented by formula (X) is useful for inhibiting asthma, atopic dermatitis, nettle rash, allergic bronchopulmonary aspergillosis, allergic eosinophilic gastroenteritis, glomerulonephritis, nephropathy, hepatitis, arthritis, rheumatoid arthritis, psoriasis, rhinitis, conjunctivitis or ischemia-reperfusion injury, for treating multiple sclerosis, ulcerative colitis, acute respiratory distress syndrome, shock accompanied by bacterial infection, diabetes mellitus or autoimmune disease, for preventing transplanted organ rejection reaction, immunosuppression or metastasis, or as a preventive and/or therapeutic agent for acquired immunodeficiency syndrome, by controlling chemokine/chemokine receptor interaction:

wherein R1x is a formula (X-2)

or a formula (X-3):

R2x represents alkyl, alkynyl or the like; each of R3x and R4x represents H, (substituted) alkyl or the like, or R3x and R4x together represent a formula (X-4):

and R5x represents H or alkyl (e.g., WO 02/74770).